I am an Assistant Professor in the Department of
Medicine and affiliate faculty of the MacLean Center for Clinical Medical Ethics
at the University of Chicago. My research combines medical ethics, health policy,
and clinical medicine to examine clinical decision-making and health care resource
allocation. I am particularly interested in three specific areas: (1) patient-physician
decision-making regarding prescription drugs, (2) broader patterns of prescription
drug utilization, and (3) the doctor-patient relationship.
During a research fellowship, I conducted a study examining patient-physician communication about out-of-pocket costs. This project has led to several follow-up projects, including the identification of barriers to communication, strategies that physicians can use to assist patients burdened by out-of-pocket costs, and consideration of new ethical challenges to physicians in the era of cost-sharing. Most recently, I have begun developing a randomized controlled trial of a behavioral intervention to promote patient-physician communication about prescription costs.
I am also interested more generally in broader patterns of prescription drug utilization. For example, in one study, my colleagues and I examined international differences in hypertension treatment and control in Western Europe and the United States. We found that lower treatment thresholds and more intensive treatment contribute to better hypertension control in the United States compared with the Western European countries studied. In another study, we explored the diffusion of a new class of pharmaceuticals, Cox-2 inhibitors, beyond the population that stood to gain the most from their use. Our findings demonstrated the challenge of limiting innovative therapies to the settings in which they are initially targeted and maximally beneficial. Currently, we are continuing work in pharmacoepidemiology by conducting policy analyses of recent changes in pharmaceutical coverage for millions of Americans.
A final area of research has used both quantitative and qualitative work to articulate contemporary challenges to physician professionalism and the changing nature of the patient-physician relationship. These examinations have included studies analyzing public and physician support for the deception of insurance companies, physicians' attitudes and experiences with retainer ("concierge") practices, and physicians' professional obligations in the cost-sharing era.
During a research fellowship, I conducted a study examining patient-physician communication about out-of-pocket costs. This project has led to several follow-up projects, including the identification of barriers to communication, strategies that physicians can use to assist patients burdened by out-of-pocket costs, and consideration of new ethical challenges to physicians in the era of cost-sharing. Most recently, I have begun developing a randomized controlled trial of a behavioral intervention to promote patient-physician communication about prescription costs.
I am also interested more generally in broader patterns of prescription drug utilization. For example, in one study, my colleagues and I examined international differences in hypertension treatment and control in Western Europe and the United States. We found that lower treatment thresholds and more intensive treatment contribute to better hypertension control in the United States compared with the Western European countries studied. In another study, we explored the diffusion of a new class of pharmaceuticals, Cox-2 inhibitors, beyond the population that stood to gain the most from their use. Our findings demonstrated the challenge of limiting innovative therapies to the settings in which they are initially targeted and maximally beneficial. Currently, we are continuing work in pharmacoepidemiology by conducting policy analyses of recent changes in pharmaceutical coverage for millions of Americans.
A final area of research has used both quantitative and qualitative work to articulate contemporary challenges to physician professionalism and the changing nature of the patient-physician relationship. These examinations have included studies analyzing public and physician support for the deception of insurance companies, physicians' attitudes and experiences with retainer ("concierge") practices, and physicians' professional obligations in the cost-sharing era.
G. Caleb Alexander MD, MS Office: 773-834-9177 Fax: 773-834-2238
5841 S. Maryland Avenue, MC 2007, Chicago, IL 60637 galexand@uchicago.edu | Maps & Directions
5841 S. Maryland Avenue, MC 2007, Chicago, IL 60637 galexand@uchicago.edu | Maps & Directions
